FDA Adverse Event Malfunction Summary report: N

BIOSURE INSTRUMENTS

MDR report key: 4791730 · Received May 22, 2015

Report

Report Number
1219602-2015-00110
Event Type
Malfunction
Date Received
May 22, 2015
Date of Event
April 23, 2015
Report Date
April 23, 2015
Manufacturer
SMITH & NEPHEW, INC.
Product Code
NBH
PMA / PMN Number
EXEMPT
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
UK
Reporter Occupation
MEDICAL EQUIPMENT COMPANY TECHNICIAN/REPRESENTATIVE

Narratives

Additional Manufacturer Narrative · 1

ALTHOUGH ANTICIPATED, THE DEVICE HAS NOT BEEN RECEIVED FOR ANALYSIS. (B)(4).

Additional Manufacturer Narrative · 1

TWO DEVICES WERE RETURNED FOR EVALUATION. IT WAS CONFIRMED THAT THE PARTS ARE LASER MARKED WITH ¿NOT FOR HUMAN USE.¿ AS A RESULT OF THIS INCIDENT A CORRECTIVE AND PREVENTATIVE ACTION HAS BEEN INITIATED. THE ROOT CAUSE INVESTIGATION IS UNDERWAY. (B)(4).

Description of Event or Problem · 1

INCORRECT MARKING - THIS UNIT ARRIVED AT THE DISTRIBUTION CENTER AS MARKED - NOT FOR HUMAN USE. THE UNIT WAS SENT OUT TO A CUSTOMER BY A MATERIALS STAFF MEMBER AS THEY WERE NOT AWARE OF THIS WHEN IT SHIPPED. NO CASE, NO PATIENT IMPACT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
337022 BIOSURE INSTRUMENTS BIOSURE RATCHET DRIVER NBH SMITH & NEPHEW, INC. 72201888 50536704

Patients

Seq Age Sex Outcome Treatment
1